What is Central Sleep Apnea (CSA) and how does it differ from other sleep-related breathing disorders?

Central Sleep Apnea (CSA) is a type of sleep-related breathing disorder characterized by interruptions in breathing during sleep due to a failure of the brain to send appropriate signals to the muscles responsible for respiration. Unlike obstructive sleep apnea (OSA), where the airway becomes blocked or narrowed, CSA originates from a problem in the central nervous system’s respiratory control centers. This results in a lack of effort to breathe rather than physical obstruction. As a result, the individual experiences pauses in breathing, or apneas, which can lead to oxygen desaturation and sleep disturbances. CSA can occur in various forms. One common form is Cheyne-Stokes respiration (CSR), often associated with congestive heart failure. In CSR, breathing gradually waxes and wanes in a rhythmic pattern, leading to periodic central apneas. Another form is idiopathic CSA, where the cause is unknown and unrelated to other medical conditions. Complex sleep apnea syndrome, also known as treatment-emergent central sleep apnea, involves a combination of obstructive and central apneas and can occur in individuals initially diagnosed with OSA who are undergoing continuous positive airway pressure (CPAP) therapy. The distinction between CSA and other sleep-related breathing disorders lies in the underlying cause. While OSA is primarily caused by physical airway obstruction, CSA stems from a lack of proper signalling from the brain to control breathing. This fundamental difference drives the diagnostic and treatment approaches. CSA often requires specialized evaluation and treatment, as addressing the central nervous system’s dysfunction is essential to managing the condition effectively.